NCQA Seeks Public Comment on a New Accreditation for Wellness and Condition Management and Updates to PCMH Recognition

NCQA seeks feedback on a new Accreditation for Wellness and Condition Management and updates to the Patient-Centered Medical Home (PCMH) Recognition program. Reviewers can submit comments to NCQA in writing via the Public Comment website by 11:59 p.m. (ET), Friday, April 17.

Join us for a webinar on March 18 at 2:00 p.m. (ET) to learn more about the proposed changes.

About NCQA’s Public Comment

NCQA releases program updates for public comment to generate thoughtful feedback and suggestions from interested parties. Many comments result in updates to our standards and policies, helping to strengthen them for all stakeholders. NCQA asks respondents to evaluate whether the proposed requirements are feasible as written and clearly articulated, and to identify areas that may need clarification.

Summary of Proposed Changes

Below is a summary of the proposed changes to NCQA’s programs and standards. You can review the full details on NCQA’s website.

New Accreditation Program for Wellness and Condition Management

NCQA is launching a new Accreditation program— Wellness and Condition Management— using our Wellness and Health Promotion Accreditation program as the foundation. The new program will assess vendors’ ability to empower members to manage their own health across the risk continuum, accounting for risk factors and condition-specific needs. It will create a common quality framework for purchasers and vendors.

The program’s content was informed by robust customer and market engagement—which continues through our new learning collaborative—and reflects the increasing use of digital vendors by health plans, health systems and employers. It shifts from prescriptive requirements toward more flexible and transparent expectations, while still holding organizations accountable for quality, equity and measurable impact.

The new program will include core standards and two modules: Health Assessment and Digitally Enabled Engagement. Organizations may participate in one or both modules. The updated standards will be released in July 2026, with an effective survey date on or after January 2027.

Patient-Centered Medical Home (PCMH) Recognition Updates

Proposed updates to the PCMH Recognition program aim to align standards with the changing market landscape, stakeholder needs and regulatory requirements, and to assist organizations in their pursuit of high-quality care.

For surveys beginning January 1, 2027, NCQA proposes updates to three core criteria within the Care Management concept:

• CM 01: Identifying Patients for Care Management
• CM 02: Monitoring Patients for Care Management
• CM 04: Person-Centered Care Plans

We also propose the retirement of one elective criterion, which will be incorporated into CM 04:

• CM 07: Patient Barriers to Goals

Proposed updates address challenges some practices experience when applying current criteria across diverse clinical contexts (e.g., health conditions, populations, case mix). They are designed to better clarify the purpose and expected outcomes of the Care Management concept’s activities and to support individualized, meaningful care plans that reflect the varied needs of patient populations.

How to Participate in Public Comment

Visit My NCQA to submit comments through our new and improved public comment process. We’ve completely redesigned the experience by reducing clicks and organizing topics more logically. These updates enable NCQA to ask more meaningful questions and make it simpler for you to share feedback.

The public comment period ends at 11:59 p.m. (ET) on Friday, April 17. For details on proposed changes, visit the NCQA website.

Join our webinar, Updates to PCMH Recognition and the New Wellness and Condition Management Program, on March 18 at 2:00 p.m. (ET) to learn more.